The Linn-Mar Community School District seeks to provide a safe environment for students, staff, and visitors who are at risk of potentially life-threatening incidents including severe allergic reactions, respiratory distress, and opioid overdose. Therefore, it is the policy of the district to annually obtain a prescription for epinephrine delivery systems and/or opioid antagonists from a licensed health care professional, in the name of the district, for administration by a school nurse or personnel trained and authorized to administer to a student or individual who may be experiencing an anaphylactic reaction, respiratory distress, or acute opioid overdose.
PROCUREMENT AND MAINTENANCE OF SUPPLY
The district shall stock a minimum of the following for each attendance center:
- Two epinephrine delivery systems; and
- Two doses naloxone or other opioid antagonist.
The supply of such medications shall be maintained in a secure, easily accessible area for an emergency within the school building, or in addition to other locations as determined by the district. Each Automated External Defibrillator (AED) box in each school building must contain one dose of Naloxone or another opioid antagonist, stored in a temperature-controlled environment. Naloxone nasal spray kits stored within the AED boxes will be inspected, at a minimum of one time per month to ensure the medication is present, secure, and within its expiration date.
The school nurse or trained and authorized personnel shall routinely check the stock of medication, Naloxone nasal spray, and AED and document in a log monthly:
- The expiration date;
- Any visualized particles or color change for epinephrine delivery systems;
- Inspection and monitoring of Naloxone nasal spray supplies; or
- AED safety check, AED battery expiration, and pad expiration date(s).
The school nurse or trained and authorized personnel shall be responsible for ensuring the district replaces, as soon as reasonably possible, any logged epinephrine delivery system or opioid antagonist that is empty after use, damaged, or close to expiration. The district shall dispose of stock medications and delivery devices in accordance with state laws and regulations.
TRAINING
A school nurse or personnel trained and authorized may provide or administer any of the medications listed in this policy from a school supply to a student or individual if the authorized personnel or school nurse reasonably and in good faith believes the student or individual is having an anaphylactic reaction, respiratory distress, asthma or other airway-constricting disease, or opioid overdose. Training to obtain a signed certificate to become personnel authorized to administer an epinephrine delivery system or opioid antagonist shall consist of the requirements of medication administration established by law and an annual anaphylaxis, asthma, other airway-constricting disease, opioid overdose training program approved by the Iowa Department of Education.
Authorized personnel will be required to retake the medication administration course, training program, and provide a procedural skills demonstration to the school nurse demonstrating competency in the administration of stock epinephrine delivery systems or opioid antagonists to retain authorization to administer these medications if the following occur:
- Failure to administer an epinephrine delivery system or opioid antagonist according to generally accepted standards of practice (“medication error”); or
- Accidental injury to school personnel related to improperly administering the medication (“medication incident”).
REPORTING
The district will contact emergency medical services (911) immediately after a stock epinephrine delivery system or stock opioid antagonist is administered to a student or individual. The school nurse or authorized personnel will remain with the student or individual until emergency medical services arrive.
Any administration of Naloxone nasal spray provided through the district's Naloxone Program shall be reported to the Department of Health and Human Services (Iowa HHS) within 30 calendar days of administration. Reports shall be submitted by email to the State Opioid Response Help Desk at sor@hhs.iowa.gov and shall include only the date of administration and the outcome of the intervention.
Within 48 hours, the district will report to the Iowa Department of Education:
- Each medication incident with the administration of stock epinephrine or opioid antagonist;
- Each medication error with the administration of stock epinephrine or opioid antagonist;
- Administration of any Naloxone nasal spray; and
- Administration of a stock epinephrine delivery system or opioid antagonist.
As provided by law, the district, board, authorized personnel or school nurse, and the prescriber shall not be liable for any injury arising from the provision, administration, failure to administer, or assistance in the administration of an epinephrine delivery system or opioid antagonist provided they acted reasonably and in good faith.
The superintendent may develop an administrative process to implement this policy.
Adopted: 4/16
Reviewed: 11/17; 12/20
Revised: 3/23; 4/23; 8/23; 2/26; 9/26
Related Policy: 504.31; 504.31-E1-E4
Legal Reference (Code of Iowa): §§ 135.185, .190; 279.8; 281 IAC 14.3; 481 IAC 620
IASB Reference: 804.05
Mandatory Policy